aqumada

Inkwan a deresachu!!!!  Sorry it took so long to get back, but I wrote a blog that never got posted.  I complained and now yekolotemari has given me a set of keys to the family car.  And unlike Wegesha, I love driving.   Yet similar to Wegesha, I am delaying the beginning of my medical training during alternative activities.  For him it was a personal social experiment involving rapid STD transmission, and for me . . . it is the same. . . .  (By the way, Dr. W, if you get a break between cases and can recommend a good anti-pruitic lotion I would be grateful).  On the side I am also working in the field of public health. 

During this year I have become interested in among other things, intellectual property and pharmaceutical drugs.  I find drug pricing to be a fascinating field: there is gamesmanship to maintain profits, failing business models that everyone hates but fears the alternatives even more, and market flaws that preserve inequity among the poor and uninsured denying access to medications by those who need them most.  In some senses it is depressing, but it also amusing . . . highly technical economics papers, expensive governmental lobbying, and endless debate mask the underlying issue—the pharmaceutical firms do not operate in a vacuum.  They are beneficiaries of significant investments by the US government in drug research that are transferred to the private companies for minimal payments.  The pharmaceutical firms spend a large percentage of their budgets not just on molecular synthesis or trials, but their marketing pipeline.  Last week, Pfizer closed some operations here in NY—these layoffs were not industrial positions but rather largely redundant sales forces.  If you have no drugs to sell, why employ so much sales personnel?  Also a lot of pharmaceutical firms have realized something: doctors like free food and pens, but don’t like being pestered by drug pushers no matter how many post-its they bring. 

My epiphany came last Monday—I was at a NYU-Columbia law class that featured drug industry reps and reduced drug pricing advocates.  I thought I was going to see fists flying, sharp suits and sharper facts.  Instead I sat next to a fat white dude with some worn brown shoes that only matched my most recent bowel movement.  Only one guy was prepared (he happens to be the reason I came to this talk).  He had facts, crafted proposals, and his responses to questions were insightful and deliberate.  Adjacent to him was a German human rights guy (paradox?) whose proposals generally revolved around condescending critiques of his counterpart.  Yet somehow Mr. Critical’s arguments were often based upon the other advocate’s facts.  What’s more is that given the backdrop of calling the other’s proposals as naive and unrealistic, his proposal to fund more equitable drug distribution called for paying companies only if countries’ disease rates declined.  As someone in the medical field, I can tell you that a lot goes into getting a drug from the company warehouse into the mouth of the patient.  Distribution, efficient market transactions, physician access, and compliance with prescribed orders are among the factors necessary for an effective drug to have an effect.  From an economic perspective, how in the hell can a company do all of these things on a national scale let alone in a continent???!!!!!  If this was my only contribution to a conversation, I’d be either silent or kissing up to everyone else.  I hate intellectually lazy people who can only criticize without being original.  And then there was doody shoes who turned out to be a Pfizer representative!  Only when he talked instead of featuring the shrewd lawyer-proof arguments I expected, he simply countered claims by the prepared advocate. 

I came to this event expecting to be challenged and inspired.  Instead I stumbled across a circuit of slackers, postponing the inevitable.  The only certainty was of protecting egos and self interests.  This night was not exciting but seemed to be a part of a larger spectrum: one of many games played by the same group of people and outlooks.  The only thing that would have made this night worth it would have been if I had gotten some free Viagra samples . . . . for my "friend."